The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur.
This finding is associated with which congenital heart defect?
Pulmonary stenosis
Patent ductus arteriosus
Ventricular septal defect
Coarctation of the aorta
The Correct Answer is B
This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.
Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.
Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.
Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
choice D. Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia. This is because a macrosomic infant (a newborn who’s much larger than average) is at risk of developing low blood sugar levels after birth, especially if the mother has diabetes. Hypoglycemia can cause neurological damage in the newborn, so it is important to detect and treat it promptly.
Choice A is wrong because leaving the infant in the room with the mother without monitoring the blood glucose levels may miss signs of hypoglycemia and delay treatment.
Choice B is wrong because taking the infant immediately to the nursery may separate the infant from the mother and interfere with breastfeeding, which can help prevent hypoglycemia.
Choice C is wrong because performing a gestational age assessment to determine whether the infant is large for gestational age is not urgent and does not address the risk of hypoglycemia.
Normal ranges for blood glucose levels in term infants are 2.6 mmol/L or higher at any time. A blood glucose level of 2.5 mmol/L or less is considered hypoglycemic.
Correct Answer is ["B","C"]
Explanation
The child’s care should include adequate hydration and pain management. The management of an acute event of a vaso-occlusive crisis is the use of potent analgesics (opioids), rehydration with normal saline or Ringer’s lactate, treatment of malaria (whether symptomatic or not) using artemisinin combination therapy, and the use of oxygen via face mask, especially for acute chest syndrome.
Choice A is wrong because correction of acidosis is not a specific intervention for the vaso- occlusive crisis.
Acidosis may occur as a complication of sickle cell disease, but it is not the primary cause of the crisis.
Choice D is wrong because the administration of heparin is not recommended for the vaso-occlusive crisis.
Heparin is an anticoagulant that may increase the risk of bleeding and does not prevent or treat the sickling process.
Normal ranges for hemoglobin are 11.5 to 15.5 g/dl for children after 2 years of age.
Normal ranges for reticulocyte count are 0.5% to 1.5% for adults and 0.5% to 2.5% for children.
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